Wednesday, March 25, 2009

Surveillance hit by Naxal menace

Bibhuti Barik

First Published : 24 Mar 2009 03:41:00 AM ISTLast Updated : 24 Mar 2009 03:49:13 PM IST

BHUBANESWAR: The growing Naxal menace in the tribal pockets — especially in the bordering districts of Orissa — has jeopardised the health-care sector too. For, the tuberculosis eradication drive has been seriously hit in the process as neither the locals dare to come to the nearest community health centres (CHCs) for detection nor the health workers reach them regularly for the usual door-to-door survey and assistance.

Situation in districts like Malkangiri, Mayurbhanj, Sundargarh and even Keonjhar - where the prevalence of TB is high among tribal communities - is becoming ‘alarming’ as the benefits of the Revised National Tuberculosis Control Programme (RNTCP) cannot reach the target population.

For example, two blocks in Mayurbhanj — Bijatala and Gorumahishani —bordering Jharkhand, the programme remains a non-starter due to increasing extremist activities in the localities, according to Health Department officials here.

Even benefits of the information, education and communication (IEC) activities for awareness generation on the killer disease are not effectively reaching people at the grass-roots and in the traditional tribal pockets other than the Naxal-hit areas, admits officials.

"As a result, maximum detected persons are not completing the mandatory six-nine months course of taking medicine under Direct Observed Treatment Short Course Chemotherapy or DOTS. After 1-2 months of drug administration, they feel better and abandon the idea of completing the full course," says State TB officer Dr Gangadhar Rath.

Many died of TB in these tribal areas for late arrival after detection, alcoholism, shifting base or migration and the failure of IEC activities. These are again due to extremist activities and inaccessible locations, he adds.

Speaking to this paper on the eve of World TB Day tomorrow, Dr Rath, however, informs since the inception of RNTCP till 2008, a total of 3,11,765 TB cases were detected and treated under DOTS and 2,21,199 have been cured and completed treatment. As per reports of the fourth quarter of 2008, the case detection rate is 60-72 per cent against the national average of 70 per cent and the most important part is that the State’s success rate is 87 per cent against the national average of 85.

RNTCP, which started in Costa CHC of Mayurbhanj on October 3, 1997, covered all districts by December 2004, but there are hurdles like natural calamities, communal tensions and the Naxalite menace complete success of the programme, he clarifies.

Killer disease

Though fever, lingering cough and blood in the sputum with severe weight loss are some known symptoms of TB, malnutrition and unhygienic conditions (cramped surroundings) may contribute towards its spread.

But as the disease strikes when the body immunity level is low, persons with diabetes should be on alert. Also those who suffer from HIV are 80-90 per cent prone to contract TB, says city-based physician Dr Paresh Jena.

It is TB rather than AIDS which takes heavy toll in India, he says.

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